Imaging prices at SageWest Health Care (Riverton Campus)
Riverton, WY · every code in this section with a posted price and a Medicare benchmark.
100 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Angio pulmonary bilat (75743) | $633.60 | $1,056 | 0.2× |
| Ankle 2 views (73600) | $282 | $470 | 3.2× |
| Arthrogram ankle (73615) | $459 | $765 | 1.3× |
| Arthrogram Wrist (73115) | $526.80 | $878 | 1.5× |
| Bone age studies (77072) | $179.40 | $299 | 1.7× |
| Bone survey infant (77076) | $190.20 | $317 | 1.8× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $1,270.80 | $2,118 | 3.6× |
| Cat Scan Follow-Up Study (76380) | $340.80 | $568 | 3.8× |
| Cholecystography Oral Contrast (74290) | $306.60 | $511 | 1.7× |
| Contrast X-Ray Of Elbow (73085) | $526.80 | $878 | 1.5× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $650.40 | $1,084 | 3.6× |
| CT colonography screening (74263) | $450 | $750 | 1.8× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) | $300 | $500 | 1.7× |
| CT head/brain without and with contrast (70470) | $1,060.20 | $1,767 | 5.9× |
| CT lower ext w/o (73700) | $896.40 | $1,494 | 8.4× |
| CT lumbar spine w/o contrast (72131) | $1,027.80 | $1,713 | 9.6× |
| CT maxillofacial wo contrast (70486) | $1,021.20 | $1,702 | 9.6× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,087.80 | $1,813 | 6.1× |
| CT orbits w/o contrast (70480) | $583.20 | $972 | 5.5× |
| CT pelvis w&w/o contrast (72194) | $1,102.80 | $1,838 | 6.2× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $667.80 | $1,113 | 3.7× |
| Dxa Bone Density Axial (77080) | $210.60 | $351 | 2.0× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $100.80 | $168 | 1.1× |
| Esophagram (74220) | $432.60 | $721 | 2.4× |
| Foot 2 views (73620) | $238.80 | $398 | 2.7× |
| Forearm 2 views (73090) | $265.80 | $443 | 3.0× |
| K Flow/Funct Image W/Drug (78708) | $993 | $1,655 | 1.8× |
| Knee 3 Views (73562) | $315 | $525 | 3.5× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $1,060.20 | $1,767 | 2.6× |
| Mammary ductogram or galactogram multiple (77054) | $348.60 | $581 | 1.4× |
| Mammary ductogram or galactogram single (77053) range across 2 matching MRF lines |
$279.60–$435 | $466–$725 | varies |
| MRA neck w contrast (70548) | $1,270.80 | $2,118 | 3.6× |
| MRI any jt upper extremity w/contrast matrl (73222) | $1,270.80 | $2,118 | 1.6× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 2 matching MRF lines |
$306.30–$1,270.80 | $510.50–$2,118 | varies |
| MRI lumbar spine w contrast (72149) | $1,270.80 | $2,118 | 3.6× |
| MRI pelvis w/o & w contrast (72197) | $1,270.80 | $2,118 | 3.6× |
| MRI thoracic spine w/o contrast (72146) | $1,270.80 | $2,118 | 5.2× |
| MRI, dorsal spine contrast (72147) | $1,270.80 | $2,118 | 3.6× |
| MRI, joint upper extrem (73221) | $1,270.80 | $2,118 | 5.2× |
| MRI, joint upper extrem combo (73223) | $1,270.80 | $2,118 | 3.6× |
| Neck soft tissue (70360) | $189 | $315 | 2.1× |
| Optic foramina (70190) | $142.80 | $238 | 1.6× |
| Panoramic X-ray of jaws (70355) | $309.60 | $516 | 3.5× |
| Peritoneogram Rs&I (74190) | $201.60 | $336 | 0.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $313.20 | $522 | 0.6× |
| Radex elbow complete minimum 3 views (73080) | $235.20 | $392 | 2.6× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $177 | $295 | 1.7× |
| Radex fingr minimum 2 views (73140) | $199.20 | $332 | 2.2× |
| Radex foot complete minimum 3 views (73630) | $265.80 | $443 | 3.0× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $348.60 | $581 | 3.9× |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$306–$322.20 | $510–$537 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $228 | $380 | 2.6× |
| Radex Spine 1 View Specify Level (72020) | $169.20 | $282 | 1.9× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $189.60 | $316 | 2.1× |
| Radex Toe Minimum 2 Views (73660) range across 4 matching MRF lines |
$226.20–$407.70 | $377–$679.50 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) | $266.40 | $444 | 3.0× |
| Radiolog exam mandible compl minimum 4 views (70110) | $325.20 | $542 | 3.0× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $220.80 | $368 | 2.1× |
| Radiologic exam swallow function contrast study (74230) | $432.60 | $721 | 2.4× |
| Radiologic examination knee 1/2 views (73560) | $282 | $470 | 3.2× |
| Radiologic Examination Osseous Survey Limited (77074) | $308.40 | $514 | 2.9× |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) | $201.60 | $336 | 0.4× |
| Ribs bilateral 3 views (71110) | $412.20 | $687 | 3.9× |
| Rp Therapy Intravenous Administration (79101) | $315 | $525 | 1.3× |
| Shoulder 1 view (73020) range across 3 matching MRF lines |
$216.60–$306 | $361–$510 | varies |
| Skull less than 4 views (70250) | $261 | $435 | 2.4× |
| Sternoclavicular joints (71130) | $174 | $290 | 2.0× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $405 | $675 | 2.3× |
| Thoracic spine 3 views (72072) | $459 | $765 | 4.3× |
| Thoracolumbar 2 views (72080) | $154.80 | $258 | 1.7× |
| Ultrasound, abdomen limited (76705) | $579.60 | $966 | 5.4× |
| Us complete joint (76881) | $510.60 | $851 | 4.8× |
| Us head (76506) | $441 | $735 | 4.1× |
| Us ob detailed single fetus (76811) | $411.60 | $686 | 1.7× |
| Us ob limited 1 or more fetuses (76815) | $405 | $675 | 3.8× |
| Us ob transvaginal (76817) | $420.60 | $701 | 3.9× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $254.40 | $424 | 2.4× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $314.40 | $524 | 2.9× |
| Us retroperitoneal complete (76770) | $761.40 | $1,269 | 7.1× |
| Us scrotum and contents (76870) range across 2 matching MRF lines |
$37.20–$45.60 | $62–$76 | varies |
| Us transrectal (76872) | $105.60 | $176 | 1.0× |
| Wrist 2 views (73100) | $224.40 | $374 | 2.5× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $300.60 | $501 | 3.4× |
| X-ray antegrade pyelogram tube (74425) | $291.60 | $486 | 0.8× |
| X-Ray Bend Only L-S Spine (72120) | $253.80 | $423 | 2.4× |
| X-Ray Exam Hip Uni 1 View (73501) | $377.90 | $629.84 | 4.3× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $464.47 | $774.12 | 4.3× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $464.47 | $774.12 | 4.3× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $464.47 | $774.12 | 4.3× |
| X-Ray Exam L-S Spine Bending (72114) | $295.20 | $492 | 2.8× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $325.20 | $542 | 3.7× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 2 matching MRF lines |
$210.60–$380.70 | $351–$634.50 | varies |
| X-ray nose-rectum child f.b. (76010) | $162 | $270 | 1.8× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $210 | $350 | 2.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 2 matching MRF lines |
$281.40–$507.28 | $469–$845.47 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 2 matching MRF lines |
$304.20–$549.17 | $507–$915.29 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $280.20 | $467 | 2.6× |
| X-Ray Stress View (77071) | $142.20 | $237 | 1.6× |
| Xr orbits complete 4 views (70200) | $379.80 | $633 | 3.6× |
| Xr Tomogram Single Plane (76100) | $147.60 | $246 | 1.4× |
A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.